Published 4:00 am, Thursday, April 28, 2005

California lags most other states when it comes to the percentage of working residents with health insurance coverage, according to a report released Wednesday.

The study, sponsored by the Robert Wood Johnson Foundation, ranks California 32nd among states. In 2003, the most recent year for which data are available, California had 2.371 million uncovered workers, who represent 15.9 percent of the state's working population. Nationwide, 16 percent of working adults, or about 20 million people, lacked health insurance.

"These are people who are stuck in the middle," said Stuart Schear, a director with the philanthropic health care foundation. "They are above the poverty level, so they don't benefit from public programs, but they really don't earn enough money to buy health insurance in the private sector."

Counting unemployed people and children, the total U.S. population without health coverage was about 45 million in 2003, the Census Bureau has estimated.

Minnesota, at 6.9 percent, had the lowest. The state has a tradition of high employer-based insurance participation, and the state has expanded its public health programs to include more people.

California health advocates took no solace in the fact that a number of states fared worse.

"This reconfirms we're in the bottom half," said Anthony Wright, executive director of Health Access, a coalition of California community and labor groups. "While there's little to no discussion on the national level, luckily there's a robust debate on health reform at state level," Wright said.

State legislators are considering a number of proposals, from universal health coverage to the expansion of existing government programs. The Assembly Health Committee on Tuesday rejected a bill that would have required people to have basic individual health insurance.

The foundation report comes on the heels of two studies conducted for the federal government that suggest that the number of uninsured Americans could be overstated.

Actuarial Research Corp., a Washington-area health research firm, found that, using a different model to interpret census data, the number of uninsured people in 2003 was 36 million, 9 million fewer than the bureau's estimate. Another count, by the Urban Institute research group in Washington, reduced the number by about 4 million.

Charles Nelson, assistant chief of the census division for income, poverty and health statistics, said the bureau will consider the results but noted that the reduced estimates varied. "We're always looking for ways to improve our surveys and our research," he said. "This is difficult research."

Health advocates said the discrepancies were relatively minor considering the scope of the problem. "If there are 36 million who are uninsured or 50 million, it's too many," Schear said.

How states rank
The percentage of working adults who were uninsured based on 2003 data
from the Centers for Disease Control and Prevention:
Best
State Uninsured
Minnesota 6.9%
Hawaii 8.5
Delaware 8.9
District of Columbia 8.9
Massachusetts 10.3.
Worst
State Uninsured
Texas 26.6%
New Mexico 22.6
Florida 21.9
Montana 21.4
Oklahoma 20.6
California 15.9%
U.S. average 16.0%
Source: Robert Wood Johnson Foundation